Three years later: Was the massive humanitarian response in Haiti a success?

Co-authored by Tom Murphy

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Immediately after the 2010 quake, many Haitians were given tents as 'temporary' shelters. Three years later, nearly 400,000 still live in them.              UNDP
Immediately after the 2010 quake, many Haitians were given tents as ‘temporary’ shelters. Three years later, nearly 400,000 still live in them. UNDP

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The international community’s response to the catastrophic 2010 earthquake in Haiti was one of the largest disaster relief responses ever carried out involving many governments, agencies, hundreds of humanitarian organizations and about $9 billion in private donations and foreign government assistance.

So it may be a bit disconcerting that, three years on, the aid and development community still can’t seem to agree on whether the effort should be regarded as largely a success or a failure.

“There are still something like 360,000 people living in tents,” said Nicole Phillips, a human rights attorney with the Institute for Justice and Democracy and Haiti. Philips is speaking today at the University of Washington along with documentary filmmaker Michele Mitchell who is screening her film Haiti: Where Did the Money Go? – a critical analysis of the lack of accountability within the humanitarian community.

Vijaya Ramachandran
Vijaya Ramachandran

Other aid experts, like Vijaya Ramachandran at the prestigious DC-based think tank the Center for Global Development, have asked the same question. As Ramachandran wrote last spring:

The Government of Haiti has received just 1 percent of humanitarian aid and somewhere between 15 and 21 percent of longer-term relief aid. As a result, NGOs and private contractors in Haiti have built an extensive infrastructure for the provision of social services. Yet, these entities appear to have limited accountability….

But many of those who actually do the work there say this alleged lack of adequate financial accountability doesn’t necessarily mean Haitians did not benefit, that lives were not saved and that many millions of people’s lives have been improved.

JeffWright2“There’s a reason it’s called a disaster,” said Jeff Wright, emergency operations manager for World Vision and a disaster relief worker with lots of experience in Haiti. These situations are always chaotic and hardly ideal for precise bookkeeping, Wright said, adding that Haiti was chaotic and difficult before the quake.

“Are things in Haiti good today? No. Are they better than they would have been had we not responded? Absolutely.”

World Vision and five other humanitarian organizations, Wright said, fed and got water to anywhere from 2.5 million to 3 million people every day for many months (with many of the supplies provided by the UN). The Christian aid organization, which had already been working on longer-term poverty issues in Haiti before the quake, alone provided 200,000 people with emergency shelters and got some 8,000 children without family support into child protection programs, he said.

Moreover, he said, World Vision has accounted for its spending in a fairly extensive report available online. In summary, the organization over the past three years has raised nearly $230 million and spent nearly $218 million in Haiti.

“How many people are alive today who wouldn’t have been if not for this massive aid response?” Wright said. It’s impossible to document the deaths averted or the suffering that’s been avoided, he said, which makes the accountability and transparency complaint one of those benefits afforded experts engaging in hindsight.

But Ramachandran said the problem is that much of the money for many long-term relief and development projects in Haiti is still largely bypassing the Haitian government and remaining in the pockets of humanitarian organizations.

“Right now what we’ve got is a process dominated by donors and NGOs,” Vijaya said recently. “The government is almost a bystander.”

Phillips agreed that this remains a problem, but acknowledged that this is also due to the dysfunction of the Haitian government — which, in addition to having suffered over the years from repeated meddling by the U.S. government, was further destabilized by the fact that the capitol city of Port-au-Prince was the epicenter for the massive quake.

“The quake devastated government,” Phillips said. “But it’s also hard to see how (the alleged US government roles in) ousting two democratically elected leaders contributes to stability within the Haitian government.”

The inability of the Haitian government to coordinate its nation’s disaster relief response led to a messy, uncoordinated flood of humanitarian efforts after the quake. Imagine if the U.S. government instead of launching a coherent military attack on Iraq instead decided to have hundreds of private militias rush in to ‘free the country’ from Saddam Hussein. Though probably all of the humanitarian efforts were well-intended, lack of coordination caused its own problems.

“Yeah, I think it’s fair to say the Haiti quake exposed to the world just how challenging, and necessary, it is to coordinate a major disaster relief response,” Wright said. The United Nations eventually took the lead in coordinating it, he said, but ideally it should always be in close partnership with the government.

The UN’s role in Haiti remains controversial as well, mostly because one team of Asian peacekeepers are believed by most experts to have caused the deadly cholera outbreak due to poor sanitation. Haiti, prior to the relief effort, had been free of cholera and now the waterborne infectious disease is widespread having killed nearly 8,000 people so far.

The UN has yet to acknowledge responsibility for the outbreak but has since attempted to use its clout to push donors to help fund a massive water and sanitation improvement project there. The UN this week highlighted progress made, which is nicely summarized in this post by UN Dispatch. And a UN News report yesterday emphasized the gains made in Haiti especially in terms of child nutrition. Yet …

“Haitians remain very angry with the UN for not taking responsibility for its gross negligence on cholera,” noted Phillips.

Instead of waiting for the revamp of Haiti’s water and sanitation infrastructure, some have been pushing the use of a new cholera vaccine to stem the outbreak. Paul Farmer’s group Partners in Health and a Haitian health NGO called GHESKIO, led by Bill Pape, have been promoting this somewhat novel approach to disaster relief.

“About 100,000 people have been vaccinated so far … which is an important first step demonstrating that this can be done and is effective,” said Helen Matzger, who heads up cholera and typhoid vaccine work at the Bill & Melinda Gates Foundation. Matzger said they recognize the long-term solution is infrastructure improvement, but she said this use of vaccines to stem cholera outbreaks in emergency situations represents a ‘sea change.’

Other Northwest-based humanitarian organizations working now on improving Haiti’s long-term recovery include Mercy Corps and Global Partnerships. Neither were operating in Haiti before the quake but both were prompted to beef up longer-term investment in fighting poverty and improving lives because of the 2010 devastation.

“Whenever we go into an emergency, we are always looking to the long horizon,” said Amy Hause, a senior program officer with Mercy Corps who works in Haiti, Kosovo and Georgia (the country, not the Peach state). “The quake really brought to the surface the lack of resiliency in Haiti, which is what we’re trying to address.”

Mercy Corps has launched a number of small projects across the poor island nation — a watershed improvement project known as Vie, Te Eneji (Creolo for ‘life, land and energy’), an HIV prevention program using youth soccer as the draw, business entrepreneurship training for women and an innovative cell-phone or ‘mobile money’ scheme with Seattle-based telecommunications firm Trilogy.

“We were the first NGO in Haiti to try to use mobile money in an emergency situation,” Hause said. The program is on hold for the moment (due to lack of cell phone company investment in the scheme, in Haiti) but she thinks it was a good demonstration project — and it emphasized putting the finances in the hands of Haitians rather than NGOs.

Hause agreed the humanitarian response to Haiti was disorganized, but she also said there’s value in de-centralization if it allows individual organizations, NGOs or even businesses to test out innovative approaches to emergency relief.

Global Partnerships is also trying something new in Haiti, aimed at assisting in its long-term recovery. The organization has long been active in funding microfinance projects, mostly in Central America. In Haiti, it is working with the leading Haitian microfinance firm Fonkoze (which also works with Mercy Corps, by the way) to fund and strengthen the health care system.

“It’s kind of an experiment for us,” said Lara Puglielli, who heads up the Haitian program of Global Partnerships. “Frankly, it’s kind of a challenge to doing anything there … We’re not sending our staff or setting up operations. Rather, we are trying to support the Haitians themselves to create self-sustaining projects and businesses.”

One of the other adverse consequences of the humanitarian response in Haiti was that all the free medical care given by outsiders ended up bankrupting local clinics and health workers. Hard to compete with free. What Global Partnerships and Fonkoze are trying to do is foster a healthy (pun intended) local health industry rather than simply expand and improve access to care.

“It can’t cover its costs right now but we design the program so that they become self-sustaining when implemented at scale,” Puglielli said.

These are just a handful of projects that sound, when taken in isolation, like progress — however frustrating and haltingly — is being made in Haiti. Mistakes were made, as they say, in the initial response. But both the humanitarian community and the Haitians continue to adapt.

“I’ve been to Haiti many times and in some ways it looks the same as it always has,” said Puglielli. “It’s tragic and can be depressing, especially because it seems like we are having the same conversations and debates in the aid and development community.”

Adds Wright: “It’s probably too early to say if we’ve learned how to do this better.”

“I just think people don’t understand how difficult this is, how complex. People tend to see what they want to see in Haiti – a glass half full or half empty … Will our successes and our failures change things? All I can say is that Haiti was certainly a landmark disaster that’s going to continue to influence what we do and how we think about aid for a long time.”

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Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org, follow him on Twitter @tompaulson and/or send a comment below.